Why the Rectal Exam Before an Enema??

Some of you in the medical field that have experience giving routine enemas may be familiar with the protocol of doing a brief digital rectal exam before inserting the tip or nozzle into the patient. We’re required to do this where I work for two specific reasons, for safety and to make the insertion of the plastic rectal tube a little less uncomfortable. It’s understandable this comes at the expense of embarrassment for the patient and makes the process a lot more stressful. And it’s usually not much help explaining to the patient that I’ve done this procedure many many times and it’s just a little thing that takes but a few seconds and it’s over with. The main safety reason for the DRE before the tube insertion is to check for internal hemorrhoids or fecal impaction or blockage, or a swollen prostate in male patients. It’s done quickly but painlessly, only 2-3 inches in the rectum and it’s over with. This important step lubricates the anal canal and dilates the internal sphincter so the enema tip will glide into the rectum with less resistance. A gloved finger with lube is a lot less traumatic than something plastic during this initial step.

I actually have less drama doing this to men because I think they’re less intimidated getting an enema from a female. I myself as a woman feel more comfortable giving an enema to a male patient because I get less drama and they’re more cooperative.

I’m explaining this coming off a stressful week doing enemas on Karens and drama queens, with only two males, and they didn’t give me a syllable of flack.

Wonderful explanation! Sounds like a perfect scenario and an amazing experience. Thanks for sharing!

I have given enemas in the hospital when i was an orderly, (1964) and the protocol was to do a dre before inserting the nozzle. Reasoning was that if the tip of the tube was buried in poo you’d have a hard time getting the enema into the bowl. in fact it would usually just start running out the rectum onto the bed. Also, if impacted you’d switch to a balloon nozzle and add more soap and raise the bag higher

My first colon therapist did it as part of the process, for the same reasons.

If you came into my room with all the essential equipment Nikki, you'd only get a big smile and a thumbs up!!!!!

I was lying in bed at home on my side when the visiting nurse named Angie said she was going to insert a gloved finger in my behind before giving me an enema. It wouldn’t hurt. She told me to take a deep breath, and it would relax “the opening.”

I was at home recovering from surgery. I was constipated from the pain medication, and Angie contacted my doctor to get approval to give an enema.

She had a tube of lubricant. She said the exam was necessary before she could insert a tube into me. I felt her finger inside me for a few seconds, and then she was done. She said everything felt normal. She changed her glove and then gave me the enema. That was my first experience getting a DRE.

Yeah I usually get a quick check before an enema or a suppository just to check they aren't going to push the thing directly into a solid lump of poo

I had a colonic at a clinic in San Diego once, and the technician said "I have to do a rectal first, it is a state requirement." Also, I went to get a colonic one time and the tech could not get the speculum inserted, I was too tight. She tried to dilate me by inserting two fingers. It did not work and I asked her to just give me an enema instead. She didn't have a bag, so I just toughed it out with the insertion, which was very painful.